March 25, 2013

From D Healthcare Daily - Covering the business of healthcare in North Texas

Texas Ceding Important Regulatory Role on Exchanges, Attorney Says

by Steve Jacob

Texas’ decision not to create a state-run health insurance exchange under the Affordable Care Act has several implications for the state’s ability to regulate its insurance market, according to a healthcare attorney.

Emily Wey, a Denver-based attorney for Polsinelli Shughart, told a recent Alliance for Healthcare Excellence luncheon gathering that federal qualification of health plans for the U.S.-facilitated exchanges moves an important insurance gatekeeper function from state control and to Washington.

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About Emily Wey

Emily Wey has extensive experience in providing guidance to health care providers on varied operational, transactional, and compliance issues applicable to these entities, from both outside counsel and in-house counsel perspectives. Ms. Wey has particular experience in the areas of private reimbursement and payer contracting (including reimbursement in integrated delivery systems) honed through working as in-house counsel for both payers and providers. This experience extends to all aspects of the cycle of payment for health care services, from network contract negotiation through dispute resolution and audits. Ms. Wey has extensive knowledge of reimbursement issues related to employer health plans, Medicare Advantage, Medicaid managed care, TriCare, Veterans Administration, and prison health care, as well as reimbursement issues related to PPACA (health care reform).
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